緩徐進行1型糖尿病疑い例への治療介入に関するステートメント

1型糖尿病における新病態の探索的検討委員会; 島田 朗; 川﨑 英二; 阿比留 教生; 粟田 卓也; 及川 洋一; 大澤 春彦; 梶尾 裕; 小澤 純二; 高橋 和眞; 中條 大輔; 能宗 伸輔; 福井 智康; 三浦 順之助; 安田 和基; 安田 尚史; 今川 彰久; 池上 博司

doi:10.11213/tonyobyo.66.807

Consensus Statement

Statement Concerning Management of Slowly Progressive Insulin-dependent Diabetes Mellitus (Probable)

The Committee of Type 1 Diabetes, Japan Diabetes Society, Akira Shimada, Eiji Kawasaki, Norio Abiru, Takuya Awata, Yoichi Oikawa, Haruhiko Osawa, Hiroshi Kajio, Junji Ozawa, Kazuma Takahashi, Daisuke Chujo, Shinsuke Noso, Tomoyasu Fukui, Junnosuke Miura, Kazuki Yasuda, Yasufumi Yasuda, Akihisa Imagawa, Hiroshi Ikegami

Author information

The Committee of Type 1 Diabetes, Japan Diabetes Society
Akira Shimada
Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University
Eiji Kawasaki
Diabetes Center, Shin-Koga Hospital
Norio Abiru
Midori Clinic
Takuya Awata
Pancreatic Islet Cell Transplantation Center, National Center for Global Health and Medicine
Yoichi Oikawa
Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University
Haruhiko Osawa
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine
Hiroshi Kajio
Department of Diabetes, Endocrinology and Metabolism, Center Hospital of the National Center for Global Health and Medicine
Junji Ozawa
Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University
Kazuma Takahashi
Department of Basic Nursing Science, School of Nursing, Iwate Prefectural University
Daisuke Chujo
Center for Clinical Research, Toyama University Hospital
Shinsuke Noso
Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine
Tomoyasu Fukui
Department of Medicine, Division of Diabetes, Metabolism and Endocrinology, Showa University School of Medicine
Junnosuke Miura
Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine
Kazuki Yasuda
Department of Diabetes, Endocrinology and Metabolism, Kyorin University School of Medicine
Yasufumi Yasuda
Division of Health Sciences, Department of Public Health, Kobe University Graduate School of Health Sciences
Akihisa Imagawa
Department of Internal Medicine (I), Faculty of Medicine, Osaka Medical and Pharmaceutical University
Hiroshi Ikegami
Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine
Chairman

JOURNAL FREE ACCESS

2023 Volume 66 Issue 12 Pages 807-814

DOI https://doi.org/10.11213/tonyobyo.66.807

Details

Abstract

Insulin treatment should be introduced for patients with slowly progressive insulin-dependent diabetes mellitus (SPIDDM) according to the revised diagnostic criteria of SPIDDM (2023). However, SPIDDM (probable) cases are in a non-insulin-dependent state, so more flexible treatment can be considered, although sulphonylurea agents should be avoided. Insulin treatment helps maintain the intrinsic insulin secretion capacity, but this does not mean that all SPIDDM (probable) cases should use insulin from the early phase. However, while DPP4 inhibitors and biguanides can be selected for treating SPIDDM (probable), no evidence yet exists concerning the efficacy of other hypoglycemic agents. Careful monitoring of the intrinsic insulin secretion capacity should therefore be performed, and if a reduction in the intrinsic insulin secretion capacity is suspected, changing the treatment should be considered in order to prevent progression to an insulin-dependent state.

Corresponding author

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